瑞德西韦治疗住院COVID-19终末期肾病患者疗效观察

V. Selvaraj, Amos Lal, A. Finn, J. Tanzer, M. Baig, A. Jindal, K. Dapaah-Afriyie, G. Bayliss
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引用次数: 2

摘要

自2019冠状病毒病(COVID-19)大流行开始以来,成人和儿童广泛使用瑞德西韦。对于接受透析治疗的终末期肾病患者,其预后知之甚少。目的评价成人终末期肾衰竭血液透析患者使用瑞德西韦的临床疗效。方法对2020年4月1日至2020年12月31日期间COVID-19治疗后出院的终末期肾脏疾病血液透析患者进行回顾性、多中心研究。主要终点是需氧量、死亡时间和需要机械通气的护理升级。结果共纳入45例患者。20例患者接受瑞德西韦治疗,25例患者未接受瑞德西韦治疗。患者多为白种人,女性糖尿病和高血压是最常见的合并症。与对照组相比,接受瑞德西韦治疗的患者需氧量(β = -25.93, X2 (1) = 6.65, P = 0.0099)、需要机械通气的概率(β = -28.52, X2 (1) = 22.98, P < 0.0001)和死亡率(β = -5.03, X2 (1) = 7.41, P = 0.0065)均有降低的趋势。结论:大规模研究瑞德西韦对终末期肾病高危人群透析的影响是合理的。
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Efficacy of remdesivir for hospitalized COVID-19 patients with end stage renal disease
BACKGROUND Since the beginning of corona virus disease 2019 (COVID-19) pandemic, there has been a widespread use of remdesivir in adults and children. There is little known information about its outcomes in patients with end stage renal disease who are on dialysis. AIM To assess the clinical outcomes with use of remdesivir in adult patients with end stage kidney failure on hemodialysis. METHODS A retrospective, multicenter study was conducted on patients with end stage renal disease on hemodialysis that were discharged after treatment for COVID-19 between April 1, 2020 and December 31, 2020. Primary endpoints were oxygen requirements, time to mortality and escalation of care needing mechanical ventilation. RESULTS A total of 45 patients were included in the study. Twenty patients received remdesivir, and 25 patients did not receive remdesivir. Most patients were caucasian, females with diabetes mellitus and hypertension being the commonest comorbidities. There was a trend towards reduced oxygen requirement (beta = -25.93, X2 (1) = 6.65, P = 0.0099, probability of requiring mechanical ventilation (beta = -28.52, X2 (1) = 22.98, P < 0.0001) and mortality (beta = -5.03, X2 (1) = 7.41, P = 0.0065) in patients that received remdesivir compared to the control group. CONCLUSION Larger studies are justified to study the effects of remdesivir in this high-risk population with end stage kidney disease on dialysis.
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